- CenterWell (Clifton Park, NY)
- …care patient services provided by clinical personnel. This role is a focused on both home health clinical quality assurance and home health clinical ... available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet… more
- CVS Health (Albany, NY)
- …Effective verbal and written communication skills - Bilingual a plus (Spanish) - Home Health experience - Associate's **EDUCATION** High School Diploma or ... At CVS Health , we're building a world of health...timelines. - Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- Catholic Health Services (Melville, NY)
- … system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the ... Overview Catholic Health is one of Long Island's finest ...date of service. The role will work closely with Utilization Management, Patient Accounts, and other key stakeholders in… more
- CenterWell (Albany, NY)
- …largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is ... **Become a part of our caring community and help us put health first** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist monitors drug… more
- Kaleida Health (Williamsville, NY)
- …Experience required. 2 years of experience in any combination of case management, home care and utilization review preferred. Knowledge of and experience with ... with members of the interdisciplinary team to coordinate care, facilitate utilization and resource management and discharge planning functions, working to achieve… more
- Evolent (Albany, NY)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...cases. you will be a key member of the utilization management team. We can offer you a meaningful… more
- CVS Health (Yonkers, NY)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...and chronically ill members with the goal of appropriate utilization , decreased length of stay, and preventable emergency room… more
- Molina Healthcare (New York, NY)
- …and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource ... management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
- Rochester Regional Health (Rochester, NY)
- …care conferences.* Supervises and evaluates care provided by Licensed Practical Nurses and/or home health aides in the performance of his/her patient care ... License Preferred Qualifications: * 1 year of nursing experienced preferred. * Prior home health , clinical and direct patient care experience preferred. HOW WE… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …NYS Nursing Licensure.* Minimum of four years clinical experience in ambulatory care, community health or home health setting.* Minimum six months experience ... position is responsible conducting face to face assessment of members in their home and/or facility. The incumbent utilizes required NYS Community Health … more